Healthcare Provider Details

I. General information

NPI: 1386786259
Provider Name (Legal Business Name): INTEGRA ACUPUNCTURE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 CROSS POINTE RD STE H
COLUMBUS OH
43230-6692
US

IV. Provider business mailing address

750 CROSS POINTE RD STE H
COLUMBUS OH
43230-6692
US

V. Phone/Fax

Practice location:
  • Phone: 614-530-0588
  • Fax: 614-626-3268
Mailing address:
  • Phone: 614-530-0588
  • Fax: 614-626-3268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000056
License Number StateOH

VIII. Authorized Official

Name: NING YANG
Title or Position: PRESIDENT
Credential: MD (CHINA), R.AC.
Phone: 614-530-0588